0307-068 (SFD)LICENSEDCONTRACTOR DECLARATION
I hereby affirm under penalty f perjury that I am licensed under provisions of
Chapter=9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date Signature of Contractor's
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( )- I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
,performance of the work for which this permit is issued.
(') I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier 10`!'h'Y.i':FUME) Policy No. 13429:37 0
(This section need not be completed if the permit valuation is for $100.00 or less).
() I certify that in the performance of the work for which this permit is issued,
I shall not employ any person -in any manner so as to become subject to the
workers' compensation laws oft California, and agree that if''I should become
subject to the workers' compensation provisionsrof Section 3700 of the Labor
Code, I shall forthwith comply with, those Tprovisions.
ate: 'T P" % Applicant
e"ID
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby, uthorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
r
1_SIgrature (Owner/Agent)-T',, 1I`',., , ` !'fs
Date
BUILDING PERMIT PERMIT�#�?
DATE Jq��I�l.� VALUATION '�jYy(yytj, LOT 3 TRACT
JOB SITE''7^:w' C...{'1.� LE aS'MALaJ
ADDRESS
APN
OWNER
CONTRACTOR / DESIGNER / EN 1NEER
CORM!Mr.I..Mr.VE' :fLFS.L"+19
C°4.L�?P+'e ,f,'C�cd�w d•.iti'Ci :c�
P.O.W"t.;819
ISA. QUINTA, CA 9n,33
LA+,•'urwr's CA 92"A S3
(%60) 64`'4604 G011 i. 11111211611
USE OF PERMIT
,taut x .:; �s.� r�� a i i.,=�. •. avu [ ajv ;:�� i.rt,� �rucic.;x: vwa�.i;h .;�,a: f��.
DRIVEWAY APPROACH.
!':�.hCT OOhlki'#'i?.UC ir':v 1,514.00 S.R
X'oRC311ifATI(. 176.0-11 3?
K191MVIEr, CION r 3AP CONORUCI ca
m<.ls i mum S'13;i'tWJsir%Y
CONSTRUCTION FEY 101.000--1'jt1,0C'O
PIAN CfitWX `r7,F, '101-006- ')9.311 tgQ6315
ILEI": DEP015Y3`r 101 42,0104
M;?.;.:74�'il'4K°AL nx 101-000-421 ,.f?0C':.
VAACTRI t! fs 1 a", 101-00041"Go $1 i l .
r•LUMBiz40WRIZ
S'i RON ;�3OTZOV4 R3, - MID 3 01 e0{f€,a-141.000
OPUADINC Pl?% 10 1- 200-42_:•070 595.00
DA`F3.,C F"SQ,r .iARN,4T F`.•? {
PRECISE?T—kN -000-44.1 -345 51{TCi,Ot3
C*0NMKETS'%i't::X13AA1s'7f.'ailli1d•CKELX.,
I YUS 1ZF-PAM t?FYS
' .425P.11^41)
p Ga D AL FERs, »Ukh;'01 �
SK M6.7
JUL 1 0 2003
CI•17110F.t..A Elul*ITA
s, '=t:t=
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Q
Exhaust Fans
O.K. to Wrap
- <j'
F.A.U.
Framing
Q
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
V.U
POOLS - SPAS
BLOCKWALL
APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
— Q
Heater Final
Water Piping
_
Plumbing Final
Plumbing Top Out
_
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
_
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) ��
CERTIFICATE OF COMPLIANCE ,,
Desert Sands Unified School District AA
l?!.'�o
47950 Dune Palms Road
q Q BERMUDA DUNES r '
Date 7/10/03 La Quinta, CA 92253 V RANCHO
IN CHHIAN MIRAGE
WELLS
No. 24687 (760) 771-8515 PALM U;T4LANy
d1QIN0 Y�
0
Owner
Coronel Enterprises
APN #
773-154-011
Address
P O Box 389
Jurisdiction
La Quinta
City
to Quinta Zip 92253
Permit #
0307-068
Tract #
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street
S.F.
Lot # No.
Street S.F.
Unit 1 1
77745 Calle Sinaloa
1514 Unit 6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping; cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
0
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 1,514 S.F. or $3,239.96 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CCNalley Independent Bank - Ish Coronel Check No. 287314
Name on the check Telephone 760/564-4604
Funding Residential`
By Dr. Doris Wilson
Superintendent
Fee collected /exempte y ShamnNcGilvrevPayment Recd 1$0.00
$3,239.96 Over/Under + C
Signature �U�44�'
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will sato notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated -
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
JAN -22-2004 08:29 PM P.09
I.\'S'1',QLA,ri0iN CERTIFICATE
7
CF -6R
G i
1•I,• •11 ' ^'F
ermit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT LEAKAGE REDUCTION
results (CFM t, 25 PA)
Test Leakage (CFM)_
` 41,'LIated a.s 400 cfrNton x number of tons, or as 21 7 x.Heating Capacity
in Thousands of Bnt/ly, enter calculated value here
If fan now is measured, enter measured value here
L v:,k.rbc•Frart!on = Test Leakage/(Measured or Calculated Fan Flow)
Pass if leakage fraction S 0.06 ❑
Fur -QI I gSOL TYPE SEALANTS ONLY • The following diagnostic testing was completed; Pr»
Duct Fan Pressurization at rough -ill measured leakage (CFM)
HECK -krrut I.i\ISHINC WAIL:
,
❑ Pressure pan test or House pressurization test ,IV/
rug ❑ �� ❑ visual Inspection of Duct Connections //TIj�+
P"4si Fji!
THERMOSTATIC EXPANSION VALVE TXV
- -------
-----------------
L '_ .: ❑ �u Themwstatic Expansion Valve (or Commission approved —
equ!valenl) is installed and Access is provided for inspection
Yes is a pass C2
DUCT DESIGN
c: ❑ �o ACOA Manual D Design calculations have been rompletcd, --
Duct Design is on the plans and duct installation matches
plans.
�✓�Nn TXV is installed or Fan flow has been verified. If no TXV, •
verified,fan flow matches design from CF_ IR.
_ r
Measured Fan Flow =
Yes for both I and 2 is a PassP
a ❑' ❑
... ass Fa.,
3
,rJer,;Rned, �rrify !hat the above diagnostic test results and the work I performed associated kvtth the tes:i s, ,,
the rcruiremenis for compliance credit. (The builder shall provide the HERS provider a.copy of the C F •tip
:mpluyees or sub contractors certifying that diagnostic testing and installation meet the rcquirrmc!i;; !0.
Si�nantrt, Date Installing Subcontractor (Co INan?e) OR
General Contractor (Co. h'amel
►a:.�La+ Department
►II:I't5 Piovider (if applicable)
=-d:ng Owner at Occupancy
JUL 24 '03
oa .
14:16 FR
REPORT OF
FiFi_D
(jtl= f -'� TO 9-5644202 P .02/02
COMPACTION TESTS ..
• OUF'REPOR7 HO.
MOISTURE
WET/DRY
I CLJENT7
ff
OATc Q3
PCF
ID NO,
I .PROJECT: - Z7 "`L/CG
•�/Lq•
CONTENT,
DENSITY,
COMPACTION
NUCLEAR CAUGE INFOAMAY)ON AND
C,',LJBRATION
DArLY STANDARD
COUNTS
CALIBRATION NUMBERS YAMATIOx, PEAGENT,.J- GAUGE Ann ST)A ENT
FROM SHEETS
7• VAAtAT10x FAO rn
LAST USE
I6
GAUGE YY DX • PBELL
MODr1 NO.: .9:.•
MOLSTURE
DEN :rrY:
MOISTURE!
R
OENSY:
I MOSTURF- MOISYURE
DENS nY: OENsrrY:
-
°ROGTOH INiORMA710N • •,
-
SOIL IQ
VISUAL CLASSIFICATION OF SOIL
I MAX. DRY DENSITY, PC`(
I OPTIMUM MOISTURE,
I
COMPACTION MOISTURE GENERAL LOCATION:
REQUIREMENTS, % REQUIREMENTS,�7TY�Li�t �s�ii
'TEST
READING QUOTIENT/
SOIL
TEST
ELEVATION
MOISTURE
WET/DRY
PERCENT
COMMENTS
NO.
PCF
ID NO,
DEPTH, IN
OF TEST
CONTENT,
DENSITY,
COMPACTION
I6
PCF
M-�
TFCHNICW111_
PI A7 tKIAL t� ULTS C ►ITLT h 3FTCIPICATIONS
XF17-L 8—COMPACTION PER=D(TAGF D0ES NOT COMPLY V4TU SPECRCAT10HS
E GOUiSE C • AertTr OF PA>=1 .S YEST
a — SUBBASE O - MOISTu{tg yr Ccc= OF SP[-mmr_AT70NS
5 - SOIL Cjvwv' T E— MOISTURE BELOW SPC6ncAtsONs
6 r OTHER
:+:W TOTAL PAGE. 02 -�-+
ZY—
I
M-�
TFCHNICW111_
PI A7 tKIAL t� ULTS C ►ITLT h 3FTCIPICATIONS
XF17-L 8—COMPACTION PER=D(TAGF D0ES NOT COMPLY V4TU SPECRCAT10HS
E GOUiSE C • AertTr OF PA>=1 .S YEST
a — SUBBASE O - MOISTu{tg yr Ccc= OF SP[-mmr_AT70NS
5 - SOIL Cjvwv' T E— MOISTURE BELOW SPC6ncAtsONs
6 r OTHER
:+:W TOTAL PAGE. 02 -�-+
,.
1
-Certificate, -.of Occopancy
%d
} _ l
GIr
Building & Safety Department
r , r j, ��- �� .~ , ' tee' -r G - • -. � c .
,This �Certificate,is issued pursuant to_ the requirements -of Section -109 of -the California Building
Code, certifying a that; at. 'the time,, , of issuance, 1his, structure was'. in compliance with.' the •
,provisions of the -Building' Code and. 66. various ordinances of -the. City," regulating : building
" ,-construction and/or use.
BUILDING"ADDRESS: 77-245 CALLE SINALOA
c Use,classificafion:'SFD Building Permit No: 0307-068.
Occupancy Group: R-3 U=1- a Type of Construction: VN Land UseZone:-RC
ti
Owner.of Building: CORONEL ENTERPRISES j Address: P.O. BOX 389
City, ST, ZIP: LA~QUIN_ YACA 92253
By: KIRK KIRKLAND
Date: 1-30-2004
u�Building Official
4� POST IN A CONSPICUOUS PLACE -